A Community-Based Investigation of Stigma Toward Individuals Receiving Methadone Maintenance Treatment in China: A Randomized Case Vignette Study

Abstract

Background: Even though methadone maintenance treatment (MMT) is effective and widely recommended, it is widely misunderstood and stigmatized. This study aimed to explore people's attitudes and beliefs toward MMT, and stigmatization of MMT patients in China.Methods: This randomized, vignette-based study enrolled 1,066 household respondents (552 males and 514 females, response rate is 88.83%, 86.00% in vignette 1 and 91.66% in vignette 2) from two communities in China. Respondents initially completed questionnaires on sociodemographic characteristics and their knowledge about methadone and MMT. They were then randomly assigned to vignette 1 (described a patient receiving MMT) or vignette 2 (described a patient receiving amlodipine treatment). The labeling, stereotyping, and social distance toward the individual described in the vignettes were evaluated.Results: In these two vignettes, respondents showed a significantly higher level of stigma and discrimination toward the patient receiving MMT than the patient receiving amlodipine treatment. Approximately 60% of respondents believed that methadone is a type of addictive drug and that participating in MMT is a way to get high. Over 60% of respondents labeled the heroin-dependent patient who is receiving MMT as an addict even though the patient has not used heroin for several years; about 80% of them believed that the patient has undesirable characteristics and expressed a strong desire for social distance.Conclusions: People's misunderstanding of MMT, and stigmatization of MMT patients were very common among populations in the communities in China. To maximize MMT patients benefiting from MMT programs, more efforts are needed to minimize the impact of MMT-related stigma.

Frontal Lobe Functions, Demoralization, Depression and Craving as Prognostic Factors and Positive Outcomes of Patients with Heroin Use Disorder Receiving 6 Months of Methadone Maintenance Treatment

“…Individuals with a better frontal assessment battery may be able to find alternative ways to deal with heroin use disorders. In addition, in the community, the use of methadone is stigmatized as it is considered an addictive drug; therefore, those who receive MMT are deemed to be “addicts” who should be avoided [ 26 ]. In the present study, the dose of methadone used was relatively low.…”

Treatments, Perceived Stigma, and Employment Outcomes among Substance Abusers in China

“…The other is employment treatment (Employment Treatment), which usually includes employment training in seeking job opportunities, and interview and job skills, depending on an assessment and the needs of the substance abuser. Nevertheless, most of the literature on treatment effects among Chinese substance abusers has focused on the effects of pharmaceutical treatment, such as Methadone Maintenance Treatment [ 40 , 41 , 42 ]. The impact of non-pharmaceutical programs has barely been investigated [ 43 , 44 ].…”

“…Chinese substance abusers, like substance abusers in other countries, face stigma and discrimination [ 40 , 45 , 46 , 47 ]. Chinese people, who live in a collective cultural society, develop self-construal with an emphasis on social relationships, and social devaluation is thus particularly harmful to their well-being [ 28 , 48 ].…”

How Anti-Substance Abuse Campaigns Influence Substance Abusers’ Psychological Health in Chinese Communities: The Mediating Role of Perceived Stigma

“…China has a large population of registered substance abusers who suffer from stigma [ 32 , 33 , 34 , 35 ]. According to a report by the China National Narcotic Control Commission (CNNCC), the number of substance abusers, defined as individuals who have been medically diagnosed with an addictive disorder and are registered in an administrative system for substance abusers, reached 1.8 million in 2020.…”

“…CDCR is one of the most important procedures for substance abusers’ recovery [ 34 ]. Nevertheless, the existing literature has focused on the effects of pharmaceutical treatment outcomes, such as the rehabilitation effects of Methadone Maintenance Treatment e.g., [ 32 , 38 , 39 ]. The impact of non-pharmaceutical programs, especially on the stigma associated with Chinese substance abusers, has barely been investigated [ 40 , 41 ].…”